Abstract
From July, 1998, to June, 1999, pneumococcal isolates from 288 patients with invasive disease in Taiwan were serogrouped and tested for their susceptibility to various antibiotics. Automated ribotyping
was used to study their molecular epidemiology. The mortality rate among those ≥65 years was higher than those 18 or 19-64 years (
p
p
= 0.017). Among strains isolated from children aged ≤18 years, 76% were not susceptible to penicillin, a rate that was significantly higher
(
p
p
Streptococcus pneumoniae
in cerebrospinal fluid was at high rate in children under 5 years (
p
= 0.00012). Molecular
typing revealed a high degree of polymorphism among the isolates. Among serogroup 23 and 19 isolates, a high proportion had the same ribotypes, the Taiwan
23F
-15 and Taiwan
19F
-14 isolates,
suggesting the circulation of a Taiwanese epidemic strain. In Taiwan,
S. pneumoniae
isolates should be tested for their resistance profile for children ≤18 years old, as these are more likely
to harbor high-level resistance. Control of pneumococcal infection with the 7-valent-conjugated vaccine should also be considered because it is estimated that it would cover nearly 90% of the serotypes
among pediatric invasive disease.